Healthcare Provider Details

I. General information

NPI: 1801080569
Provider Name (Legal Business Name): ROSEMARIE BELL CAMACHO LMHC, MFT, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 02/11/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 S MARINE CORPS DRIVE 1201 FLORA PAGO LANE
CHALAN PAGO GU
96910
US

IV. Provider business mailing address

PO BOX 12621
TAMUNING GU
96931-2621
US

V. Phone/Fax

Practice location:
  • Phone: 671-649-2081
  • Fax: 671-649-2083
Mailing address:
  • Phone: 671-727-4213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number89
License Number StateGU

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: